The Polish Sejm will review a petition proposing a split of the National Health Fund (NFZ) into two tiers, potentially altering healthcare financing.
Current Healthcare Funding System
Currently, every working person in Poland pays a mandatory health insurance contribution that goes to the National Health Fund (NFZ). This creates a single, centralized system for funding healthcare, without the option to choose an insurer.
The Issue of Dual Funding
Increasingly, individuals are paying twice for healthcare: once to the NFZ and again privately for visits, tests, and medical packages. The petition author terms this “double funding” of healthcare.
Proposed Changes: A Two-Basket System
The petition, prepared by Robert Ołdakowski, proposes dividing the health contribution into two baskets: a mandatory hospital care basket and an optional ambulatory care basket. Individuals using private ambulatory care could reduce their public contribution while maintaining mandatory coverage for life-saving treatment.
Healthcare Access and Equity Concerns
The petition argues that the current system resembles a tax more than insurance, citing long wait times for specialists, limited access to diagnostics, and a growing private healthcare market. It highlights a disconnect between contributions and actual healthcare benefits.
International Comparisons
The petition draws on models from other European countries, where some level of choice exists, and emphasizes the lack of a single-payer monopoly and a greater role for competition.
Potential Impacts of the Reform
For employees, the change could offer a choice currently unavailable. For example, someone paying for private ambulatory care could opt for a lower public contribution while retaining NFZ hospital coverage. However, the NFZ could face reduced funding, potentially impacting access for those without private insurance.
Financial Implications and Risks
The most controversial aspect is the potential financial impact on the NFZ. While the author argues it could reduce financial pressure, the loss of ambulatory care contributions could destabilize the system and make it difficult to determine appropriate basket proportions.
Legislative Outlook
While the petition’s review doesn’t guarantee legislative change, the topic is politically sensitive and requires broad consensus. A swift overhaul is unlikely, with debates and potential partial changes being the more probable outcome.
